Menopause - the end of a woman's fertile years - occurs when a woman has not had a menstrual period for a full 12 months. Menopause usually happens between ages 45 and 55. The years leading up to menopause are called perimenopause. It lasts until one full year after the last menstrual period.

What happens during perimenopause?As a woman nears the end of her childbearing years, the ovaries start producing less estrogen. During this time, your body will slowly go through changes in response to the fluctuating hormone levels.

Changes of perimenopause are brought on by both the drop in estrogen and the aging process. Specific symptoms vary from woman to woman. Hormonal changes occur gradually, so some women won't have any symptoms or they just won't feel like themselves. But other women will have several discomforts that last for years.

What are the symptoms of perimenopause?One of the main signs of perimenopause is a change in your menstrual cycle. The drop in hormones causes cycles to become irregular until they stop completely. You may have longer or shorter periods, and in some cycles ovulation may not occur.

Other common signs of menopause include:

Hot flashes. These are sudden, intense bursts of heat in your upper body and face. They can come on at any time, day or night, and last for one to 30 minutes.

Sleep disturbances. Insomnia may be caused by changes in hormones that regulate sleep cycles, and hot flashes can interrupt your sleep at night.

Mood swings. Mood changes may come from not getting enough sleep or the shift in hormones.

Vaginal dryness. The drop in estrogen causes the vaginal lining to get thin, dry and less flexible.

Incontinence. Tissue in the urinary tract is weakened due to the decline in estrogen.

Bone loss. This starts around age 35 and speeds up as the ovaries make less estrogen. This raises your risk for osteoporosis.

Change in sex drive. Sexual arousal takes longer as you age. Some women have a better sex life after menopause, while others notice a decline in their sex drive.

Is there treatment for perimenopause?Perimenopause is a natural life change that requires no treatment. Still, there are options available to relieve some perimenopause discomforts. For example:

Cope with hot flashes by dressing in layers and avoiding triggers like hot weather, hot drinks, spicy foods and alcohol.

Use an over-the-counter vaginal lubricant to reduce vaginal dryness.

Talk to your doctor about hormone therapy, which can help ease symptoms if they are severe.

How to know if I'm going through perimenopause?Make an appointment to see your doctor when you notice changes in your menstrual cycle or other signs of perimenopause. Your doctor will go over your medical history and review your symptoms before making a diagnosis.

Some symptoms need to be checked by your doctor to make sure that they are not a sign of something else. These include:

Change in your menstrual cycle

Having periods less than three weeks apart

Heavy bleeding

Spotting (bleeding between periods)

Periods that last longer than a week

Can I still get pregnant during perimenopause?Yes. It's possible to conceive at any time until menopause - 12 months after you've had your last period.

If you do not want to get pregnant, use birth control. There are many options for you. Low-dose birth control pills may be a good choice for some women going through perimenopause because they can keep periods regular and help with hot flashes and night sweats. Birth control pills are not an option for women who smoke because this raises the risk for dangerous side effects.

By Jenilee Matz, MPH, Staff WriterCreated on 05/02/2002Updated on 01/27/2010

Sources:

National Institute on Aging. Menopause.

American College of Obstetricians and Gynecologists. Midlife transitions: a guide to approaching menopause.